Provider Demographics
NPI:1881218006
Name:SABOL, CODY MATTHEW (DDS, MA)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:MATTHEW
Last Name:SABOL
Suffix:
Gender:M
Credentials:DDS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NC
Mailing Address - Zip Code:28127-9723
Mailing Address - Country:US
Mailing Address - Phone:704-322-5425
Mailing Address - Fax:
Practice Address - Street 1:127 ROYAL TROON LN
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-6970
Practice Address - Country:US
Practice Address - Phone:336-998-2427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC117871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice